Individual
MICHAEL VATHANASAYNEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3950 W LAKE MEAD BLVD, N LAS VEGAS, NV 89032-4895
(702) 737-2020
Mailing address
11714 LONGWORTH RD, LAS VEGAS, NV 89135-1322
(714) 926-4384
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
046009940
IL
152W00000X
Optometrist
Primary
609
NV
Other
Enumeration date
06/25/2007
Last updated
12/13/2012
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